Abstract A33: African American men's perceptions of the informed decision-making process for prostate cancer screening: Implications for design and development

Abstract

Abstract Introduction: Although prostate cancer mortality rates are on the decline, rates in African American men remain more than twice as high as those in white men. Men at risk for prostate cancer are encouraged to utilize informed decision making (IDM) to determine the most appropriate strategy for screening and prevention. However, multiple barriers exist in the provision of culturally and linguistically appropriate IDM models on prostate cancer for African American men, including mistrust of the health system, fear of cancer, and concerns about discrimination and racism. Multimedia approaches have been determined to be an effective means for the dissemination of culturally and linguistically appropriate IDM models for African Americans that minimize barriers within the community. Methods: Focus groups were conducted with African American men in the Tampa Bay area to determine core elements for the design of a video-based patient decision aid for prostate cancer screening. Lay health advisors from the community recruited African American men to participate in this formative research. The inclusion criteria were: African American men; aged 40 to 70 years; and no diagnosis of prostate cancer or any other type of cancer. The focus groups were transcribed verbatim and analyzed using a combination of content analysis and the constant comparison method with Atlas.ti software. Results: A total of 18 African American men, ranging in age from 41 to 65 years, were recruited (mean age=48.5 years). Overall, men had limited knowledge regarding prostate cancer, and slightly more than one-third (38.9%) of the men had previously been screened for prostate cancer. Multiple themes emerged through the conduct of focus groups, including the influence of cultural beliefs in screening, the need for more information on risk and protective factors for prostate cancer, the involvement of spouses and family members in decision-making, and the importance of culturally-appropriate educators, advocates, and role models. Conclusions: Overall, there is a lack of information regarding prostate cancer among African American men. Cultural perceptions and beliefs play a critical role in the determination of screening practices in this community. Patient decision aids on prostate cancer for African American men require the utilization of African American health professionals and peers as purveyors of information. Furthermore, messaging should be tailored for African American men, as well as their spouses and families, to aid in the determination of appropriate prevention and screening strategies. These findings will assist in the design and development of culturally and linguistically appropriate educational resources and interventions on prostate cancer for the African American community. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A33.